机械通气辅助呼吸在脑出血伴急性呼吸窘迫综合征中的应用研究

目的分析我科2007—2010年收治的44例脑出血伴急性呼吸窘迫综合征（ARDS）患者采用呼吸机支持治疗的应用经验。方法回顾我科2007年以来对脑出血伴ARDS患者采用双水平气道正压（BiPAP）通气模式进行呼吸机支持治疗及采用连续脉搏血氧饱和度（SpO2）监测和间断血气分析方法来指导呼吸机支持治疗的患者44例。结果 44例中有15例死亡,其余患者经呼吸机支持治疗1～7d后呼吸功能均得到恢复,病情稳定后转普通病房。结论 BiPAP通气模式更适用于危重患者伴ARDS需呼吸机支持治疗的患者。采用连续SpO2监测和间断血气分析方法指导呼吸机支持治疗是基层医院简便易行的监测手段。

The Application on Ventilator-assisted Breathing for Traumatic Brain Injury with Acute Respiratory Distress Syndrome

Objective To sum up and analyze the clinic application experience in respiration support treatment of 44 cases of patients suffering from cerebral hemorrhage with acute respiratory distress syndrome(ARDS) gathered by the Department of Neurosurgery of our hospital from 2009.Methods Review the adoption of bi-level positive airway pressure(BiPAP) mode supported by breathing machines and the adoption of continuous monitoring on pulse oxygen saturation(SpO2) as well as discontinuous blood gas analysis as guidance for treatment of clinic 44 cases suffering from cerebral hemorrhage with ARDS.Results Of the 44 cases,15died,and the rest recovered in respiratory functions and moved to common wards with stable status after receiving 1～7 days of treatment supported by breathing machines.Conclusion The BiPAP mode is more applicable to seriously ill patients with ARDS who are in need of supported breathing machines.The methods of continuous SpO2 monitoring and discontinuous blood gas analysis for guiding the treatment supported by breathing machines are easy and convenient monitoring means to be adopted by base-level hospitals.